Telemedicine impact on patient disparities and physician practice patterns in cancer rehabilitation: A multicenter retrospective study.
David Leong, Amy Ng, Philip Chang and 4 others
PMID 38864328WHAT IT FOUND
Telemedicine visits resulted in fewer referrals for physical and occupational therapy than in-person visits.
Prescribing medications was equally likely in both settings. Older patients and those identifying as Black or White were less likely to receive telemedicine care.
Key findings
01Physical therapy, occupational therapy, laboratory, and durable medical equipment orders were more frequent with in-person visits, while social work or case management referrals were more frequent with telemedicine.
02In the adjusted analysis, medication prescribing frequency showed no difference between telemedicine and in-person visits, but 'other' orders (which include therapy referrals) remained less frequent with telemedicine.
03Patients identifying as Asian or 'other' were more likely to have telemedicine visits, while those identifying as Black or White were less likely. In-person participants were significantly older than telemedicine participants.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The study is retrospective and observational, meaning patient and physician preferences, as well as institutional policies, influenced whether a visit was in-person or telemedicine, rather than random assignment. Clinical outcomes (such as patient function or symptom improvement) were not assessed; the study only looked at the frequency of orders placed. Socioeconomic factors like income and detailed ethnicity data were not captured, limiting the ability to fully understand disparities. The 'other' order category was heterogeneous, combining therapy referrals with labs and equipment, which may mask specific trends within subgroups. Data were collected during the COVID-19 pandemic, which may have influenced testing and imaging behaviors differently than in non-pandemic periods.
Declared interests
The authors report no conflicts of interest.
The easy way to misread this
Do not assume that telemedicine care is clinically equivalent to in-person care for functional rehabilitation. This study found fewer physical and occupational therapy referrals for telemedicine visits, but it did not measure whether those patients had worse functional outcomes or simply had different clinical needs.